Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 5502 | NC |
NPI | 1003085291 |
---|---|
Provider Name | Mr. Tim J White |
First Address | High Point, NC 27265-3501 |
Second Address | High Point, NC 27265-3501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2008 |
Last Update Date | 13/02/2009 |